What is a form PA 635 or 1663?

This Medical Assessment Form (PA 635) is needed to determine whether an individual is able to participate in employment and training activities, what treatment plan(s) could help the individual move towards employment, or determine if the individual is a good candidate for disability benefits or is pregnant.

Employability Assessment Form (PA 1663) to verify their health conditions, illnesses, and/or disabilities. This form will be submitted to the Department of Human Services (DHS) with your patient's MA application. What types of providers may complete this form? psychologists may complete Section II of the PA 1663.

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PLEASE READ INSTRUCTIONS BEFORE COMPLETING FORMCOMPLETION INSTRUCTIONS EMPLOYABILITY REASSESSMENT FORM (PA 1664) An individual with a physical or mental disability which temporarily or permanently.

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